Abstract

Iron deficiency (ID) impairs hemoglobin (Hb) synthesis and immune function, both crucial for sepsis patients. We assessed the impact of iron dextran on reticulocyte (Ret) Hb equivalent (Ret-He) and Ret subpopulations in iron-deficient sepsis patients. In this prospective clinical study we enrolled patients with sepsis or septic shock with procalcitonin concentration > 0.5 ng/mL, diagnosed with ID based on Ret-He. Study subjects received divided doses of iron dextran until normalization of Ret-He. The study population included 35 subjects. The median Ret-He increase after 2 doses of iron dextran was 3.0 (IQR 1.9–6.1) pg (p < 0.01) with median time to normalization 4 (IQR 3–5) days. Although no change in Ret percentage [Me 1.5 (IQR 1.1–2.1) vs. Me 1.4 (IQR 1.1–2.4) %, p = 0.39] and number [Me 0.05 (IQR 0.04–0.07) vs. Me 0.05 (IQR 0.03–0.06) 106/µL, p = 0.88] was noted, Ret subpopulations changed significantly (p for all < 0.01). Divided doses of iron dextran relatively quickly normalize Ret-He in iron-deficient sepsis patients. Changes in Ret subpopulations suggest increased erythropoietic activity. Further research is needed to explore the role of intravenous iron in this clinical setting.

Details

Title
Iron deficiency in sepsis patients managed with divided doses of iron dextran: a prospective cohort study
Author
Czempik, Piotr F. 1 ; Wiórek, Agnieszka 2 

 Medical University of Silesia, Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Katowice, Poland (GRID:grid.411728.9) (ISNI:0000 0001 2198 0923); University Clinical Center of Medical University of Silesia in Katowice, Transfusion Committee, Katowice, Poland (GRID:grid.411728.9) (ISNI:0000 0001 2198 0923) 
 Medical University of Silesia, Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Katowice, Poland (GRID:grid.411728.9) (ISNI:0000 0001 2198 0923) 
Pages
5264
Publication year
2023
Publication date
2023
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2793281588
Copyright
© The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.